Monday, 17 May 2010

Will Hutton to lead pay review? Are they joking?

One of the most pernicious diseases to hit the public sector under Labour is the culture of managerialism. Together with the targets, performance indicators and benchmarking, together with the Audit Commission determining exactly how each of the lowliest parts of the public sector should do its job, together with the octopus of State Central Planning that manipulated the levers, came a wave of 'modernisation'.

Here in Zone-2 London, my GP used to be overworked and underpaid, but he'd known me since I moved here and on my very infrequent visits he'd want an update on what I'd been up to in the past year as much as he'd want a blood pressure reading. He ran his list together with a part-time locum and a receptionist. Then came a tsunami of health service cash. The rather scruffy terraced shop where he used to hang his shingle was closed and a pretty Victorian villa down the road was bought and refurbed at a cost of about £3m. The receptionist was re-designated practice manager and two more receptionists hired. A nurse appeared, with her own consulting room. Two more full-time GPs turned up. The list was exactly the same size, and patients were randomly allocated to whichever had an appointments slot, strictly limited to 15 minutes.

Well, my old GP didn't take to this 'modernisation'. For a start, he'd lost 'his' list to a faceless NHS organisation. He couldn't enjoy a rambling half-hour chat about fishing any more. And the new Trust that now paid him kept giving him targets to report on; what had he done to reduce teen pregnancy / domestic violence / diabetes? So he took early retirement.

I've had to visit twice since he's gone, to what is now no longer the GP's surgery but State Health Plant Number 532. First time I got a cold and lugubrious Frenchman who peered confused at his computer screen. It took ten of our allotted fifteen minutes to work out that my records had been wrongly transcribed, and included those of a woman with Psoriasis. He rapidly scratched out a prescription to be rid of me. I looked it up. It was inappropriate. I devised my own cure with the aid of the internet. The second was a Tamil chap, no more competent. I haven't bothered going back since.

This tale is symptomatic of what's happened under Labour. At the old surgery there were no appointments, you just turned up and waited. If you weren't that sick (and many weren't) you got fed up waiting and went home. No wasted guaranteed 15 minutes. And the doc knew you, making his work more effective and efficient. And he worked maybe 60 hours a week for a £45k salary - good value.

Anyway, Will Hutton. It soon became clear that lots of doctors like my old GP and lots of patients like me were unhappy, despite the record number of tractors being serviced by the State Health Plants. So the NHS engaged Hutton's Work Foundation to survey everyone to find out exactly how unhappy we all were. Then they set performance targets to reduce the unhappiness level.

Looking at Hutton's board, you find PWC, a trade union official, the permanent secretary of the Department of Communities and a brace of senior HR and management consultants. These are the very people who have caused all the mess in the first place; these are the modernisers, who pushed their culture of managerialism into things that worked quite well, and made them work appallingly badly. These are the people who should be removed from every public procurement list in the country and never used again. But what does Cameron do? Appoint Hutton to oversee a senior salaries review.

It's madness.


Nomad said...

Quite so. Happily I am out of all this tripe now, but I can confidently say that in a fairly successful career of over 50 years I never met one so-called consultant who did not tell me what I already knew. The difference was that I had it all in my head and they had it all written down.

BrianSJ said...

culture of managerialism - nearly right - cult of managerialism.

I don't beleeeeve it.

Newmania said...

Not sure about that R , the point clearly is to reduce the salaries of senior managers but with reference to fairness rather than 'cuts'. I see Will Hutton as merely a useful idiot in this providing cover . Its going to be very hard for Public Sector staff to strike on the basis they are no longer earning 30 times as much as the lowest paid .
BTW had a bit of victory against the NHS machine the other day . I got to the dentist and was told the Dentist was running late and I would have to wait an hour .
I said ,,....ok that’s one you miss one more and you are off the NHS list .

Got a little round of applause . Go me !